DOCSLIB.ORG

Squamous Cell Carcinoma in a Pre-Existing Adult Mature Sacro-Coccygeal Teratoma: a Rare Case with Review of Literature

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Squamous Cell Carcinoma in a Pre-Existing Adult Mature Sacro-Coccygeal Teratoma: a Rare Case with Review of Literature Case Report DOI: 10.18231/2394-6792.2018.0029 Squamous cell carcinoma in a pre-existing adult mature Sacro-Coccygeal teratoma: A rare case with review of literature Ranjan Agrawal1,*, Jagdamba Sharan2, Parbodh Kumar3 1Professor, Dept. of Pathology & Surgery, Rohilkhand Medical College & Hospital, Bareilly, Uttar Pradesh, India *Corresponding Author: Email: [email protected] Abstract We report a case of sacrococcygeal teratoma with squamous cell carcinomatous transformation in a 40-year-old lady. This is an infrequent location for teratoma in adults and malignant transformation has rarely been described. The uniqueness of the present case was the presence of congenital sacrococcygeal teratoma presenting in adulthood with malignant transformation. Keywords: Malignant transformation, Sacrococcygeal, Squamous cell carcinoma, Teratoma. Received: 04th July, 2017 Accepted: Introduction non-tender, fluctuation present, non-reducible or compressible with no abnormal pulsations. The Teratomas are found with decreasing skin over the swelling was tethered in the center frequency in the gonads (ovaries and testis), but at the periphery it was free from the swelling. mediastinum, retroperitoneal space, Another swelling was present just below the sacrococcygeal region, pineal and other coccyx about 8 cm × 6cm in size and intracranial locations.1,2 Sacrococcygeal communicating with the swelling in the sacral teratomas are congenital tumour that develop region as on pressing either of the swelling the embryologically from multipotent cells and other swelling increased in size due to movement enlarge as pre and post sacral mass. As per their of fluid (cross fluctuation sign positive). degree of maturation, they are classified as Routine blood tests were within normal mature, immature, and malignant. We present an limits. The pus which was drained out showed unusual case of congenital sacrococcygeal plenty of pus cells and culture isolated coagulase teratoma in a 40 year old female, later negative staphylococci sensitive to most undergoing malignant transformation. antibiotics. No acid fast bacilli were present. USG abdomen did not show any significant Case Report abnormality except for incidental gall stones. MRI showed a large lobulated multiseptated A 40 year old female presented with an heterogenously hyperintense altered signal increasing swelling in the lower back since last 3 intensity mass lesion at posterior aspect of months. The swelling was present since birth, sacrococygeal region, with no evidence of but had increased in size recently. There was no osseous destruction, intra- pelvic extension or other significant history. Her menstrual history inflammatory changes in the peripheral was normal with regular cycles of normal myofascial plane. Under epidural anaesthesia duration and flow. Patient was married, had 6 through a vertical slightly curved incision the children all born by normal vaginal delivery at tumour was explored. Skin flaps were raised and home. She recently developed mild fever and the tumour was dissected free from the skin and sudden significant increase in the size of the adjacent tissues. There were three extensions of swelling 3 months back for which a local the tumour, one in the sacral region, second in practitioner was consulted who aspirated copious the coccygeal region and third towards the left amount of purulent fluid (300 – 400 ml) from the lateral side away from the midline reaching up to swelling. After two-and half months the swelling the skin. All the three extensions were recurred for which she was referred to this communicating with each other. Grossly, the tertiary care hospital. tumour measured more than 25×18 cm in size On local examination a swelling was noted (Fig.1). in the sacral region measuring 12 cm× 15cm in The tumour was adherent to the sacrum size covered with dark coloured skin. The local posteriorly at the site of the junction of the three temperature was not raised. The swelling was extensions which was fulgurated, two drains Indian Journal of Pathology and Oncology, January-March, 2018;5(1):161-163 161 Ranjan Agrawal et al. Squamous cell carcinoma in a pre-existing adult mature Sacro-Coccygeal… placed and the wound closed. The extragonadal. In children, sacrococcygeal histopathological examination of the resected teratomas comprise of 40% of all GCTs and up specimen suggested mature teratoma with areas to 78% of all extragonadal GCTs. of squamous cell carcinoma changes i.e., Sacrococcygeal teratoma is the most common Teratoma with malignant transformation (Figs. 2 solid neoplasm in neonates, with an estimated and 3). The malignant squamous part showed prevalence of 1 in 35 000–40 000 live births with positivity with Cytokeratin (Fig. 2b). Post- female to male ratio 4:1.1 Adult sacrococcygeal operative period was uneventful and the patient teratoma is extremely rare with an incidence of was discharged with an advice for regular follow 1:87,000 and a female to male ratio of 10:1. up. Most common are benign, also called mature teratomas. Sacrococcygeal teratomas with malignant elements generally are not seen in infants. Malignancy is very rare in adult sacrococcygeal teratomas and if present arises from the embryonic tissue. In the present case malignant change was noted in the squamous epithelium. Squamous cell carcinoma has been reported in only a single case.3 A total of 92 cases sacrococcygeal teratomas in adults, with only 20 as malignant or with malignant 1,3-5 transformation are available in the literature. Fig.1: Gross appearance of the resected Most adult sacrococcygeal teratomas are cystic specimen and benign and only 1-2% are malignant. The risk of malignancy increases with age.6 Mature Sacrococcygeal teratomas can undergo dysplastic change and frank malignant degeneration. Sacrococcygeal teratomas are thought to originate from multipotent cells in Henson’s node, which migrates caudally to rest in the coccyx. All Sacrococcygeal teratomas involve the coccyx. They may grow postero-inferiorly into the gluteal area and/or antero-superiorly into the abdomino-pelvic cavity.1,7 Most adult Sacrococcygeal teratomas are intra pelvic.4 However, there was no intra pelvic extension in the present case. Fig. 2: Microphotograph showing (a) areas of Teratomas often are comprised of cells that normal squamous lining; (b) malignant represent all three germ cell layers. They have squamous Component; and (c) malignant solid, cystic or mixed components. Unlike squamous component positive for Cytokeratin teratomas in other locations, sacrococcygeal (40X) teratomas often do not have a capsule or pseudocapsule, which contributes to the difficulty in achieving a complete resection. Exclusively pre-sacral tumours present later than those with an external component, and have a higher prevalence of malignant transformation Solid tumours are more likely to be malignant. Necrosis, poor line of demarcation of the Fig. 3: Microphotograph showing other adjacent soft tissue planes, invasion of adjacent components of teratoms – adipocytes, blood structures, destruction of sacrum, regional lymphadenopathy and distant metastases are vessels, fibrous tissue and neural tissue. (40 X) 1,4 signs suggestive of malignancy. Discussion Malignant teratomas, in addition to mature and/or embryonic tissues, have frankly malignant Germ cell tumours (GCTs) that arise outside tissue of germ cell origin, such as germinoma the testes or the ovaries are classified as and choriocarcinoma. Tumours containing malignant, non-germ cell elements, including Indian Journal of Pathology and Oncology, January-March, 2018;5(1):161-163 162 Ranjan Agrawal et al. Squamous cell carcinoma in a pre-existing adult mature Sacro-Coccygeal… adenocarcinoma and squamous cell carcinoma, 3. Chen KT, Squamous cell carcinoma arising in are referred to as teratoma with malignant sacrococcygeal teratoma. Arch Pathol Lab Med transformation. Patients with either a malignant 1980;104 (6):336. PMID: 6892874 4. B. Kostas, G. Zisis, T. Christos, K. Isaak, G. teratoma or a benign teratoma with malignant Vrakas, X. Vrakas: Sacrococcygeal teratoma in transformation have a considerable increase in adults: Report Of A Case And Literature mortality. Patients with Sacrococcygeal Review. The Internet Journal of Surgery. teratomas may be asymptomatic on initial 2007;11(2). DOI: 10.5580/fe3 presentation or may manifest a variety of 5. Robin NH, Grace K, DeSousa TG, McDonald- McGinn D, Zackai EH. New finding of Schinzel- symptoms that are not indicative of either benign Giedion syndrome: a case with malignant or malignant nature. sacrococcygeal teratoma. Am J Med Genet Imaging features alone do not allow definite 1993;47:852-6. differentiation between benign and teratomas 6. Al-Essa AA, Malik TA, Baghdadi MK, El Tayeb with malignant transformation. Tumour markers, AA. Adult sacrococcygeal teratomas.Saudi Med such as alpha-fetoprotein, carcino-embryonic J. 2004 25(3):367-9. PMID: 15048179 7. Audet IM, Goldhahn RT Jr, Dent TL. Adult antigen and human chorionic gonadotropin, are sacrococcygeal teratomas. Am Surg 2000;66.61- not helpful in differentiating between benign and 5. malignant lesions.6 8. Lopes A, Pearson S, Roberts J, et al. Case report: Surgical treatment of sacrococcygeal immature presacral teratoma in an adult female. teratomas is complete excision, inclusive of Gynecol Oncol 1990;38:135–7. coccyx and may be sacrum if involved. Coccyx may contain a nidus of pleuripotent cells that increases the recurrence rates to 37% when not excised.1,2,6 Most recurrences
Load more

Recommended publications
  • Cholangiocarcinoma 2020: the Next Horizon in Mechanisms and Management
    CONSENSUS STATEMENT Cholangiocarcinoma 2020: the next horizon in mechanisms and management Jesus M. Banales 1,2,3 ✉ , Jose J. G. Marin 2,4, Angela Lamarca 5,6, Pedro M. Rodrigues 1, Shahid A. Khan7, Lewis R. Roberts 8, Vincenzo Cardinale9, Guido Carpino 10, Jesper B. Andersen 11, Chiara Braconi 12, Diego F. Calvisi13, Maria J. Perugorria1,2, Luca Fabris 14,15, Luke Boulter 16, Rocio I. R. Macias 2,4, Eugenio Gaudio17, Domenico Alvaro18, Sergio A. Gradilone19, Mario Strazzabosco 14,15, Marco Marzioni20, Cédric Coulouarn21, Laura Fouassier 22, Chiara Raggi23, Pietro Invernizzi 24, Joachim C. Mertens25, Anja Moncsek25, Sumera Rizvi8, Julie Heimbach26, Bas Groot Koerkamp 27, Jordi Bruix2,28, Alejandro Forner 2,28, John Bridgewater 29, Juan W. Valle 5,6 and Gregory J. Gores 8 Abstract | Cholangiocarcinoma (CCA) includes a cluster of highly heterogeneous biliary malignant tumours that can arise at any point of the biliary tree. Their incidence is increasing globally, currently accounting for ~15% of all primary liver cancers and ~3% of gastrointestinal malignancies. The silent presentation of these tumours combined with their highly aggressive nature and refractoriness to chemotherapy contribute to their alarming mortality, representing ~2% of all cancer-related deaths worldwide yearly. The current diagnosis of CCA by non-invasive approaches is not accurate enough, and histological confirmation is necessary. Furthermore, the high heterogeneity of CCAs at the genomic, epigenetic and molecular levels severely compromises the efficacy of the available therapies. In the past decade, increasing efforts have been made to understand the complexity of these tumours and to develop new diagnostic tools and therapies that might help to improve patient outcomes.
    [Show full text]
  • The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes Daniel Herzig, M.D
    CLINICAL PRACTICE GUIDELINES The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Polyposis Syndromes Daniel Herzig, M.D. • Karin Hardimann, M.D. • Martin Weiser, M.D. • Nancy Yu, M.D. Ian Paquette, M.D. • Daniel L. Feingold, M.D. • Scott R. Steele, M.D. Prepared by the Clinical Practice Guidelines Committee of The American Society of Colon and Rectal Surgeons he American Society of Colon and Rectal Surgeons METHODOLOGY (ASCRS) is dedicated to ensuring high-quality pa- tient care by advancing the science, prevention, and These guidelines are built on the last set of the ASCRS T Practice Parameters for the Identification and Testing of management of disorders and diseases of the colon, rectum, Patients at Risk for Dominantly Inherited Colorectal Can- and anus. The Clinical Practice Guidelines Committee is 1 composed of society members who are chosen because they cer published in 2003. An organized search of MEDLINE have demonstrated expertise in the specialty of colon and (1946 to December week 1, 2016) was performed from rectal surgery. This committee was created to lead interna- 1946 through week 4 of September 2016 (Fig. 1). Subject tional efforts in defining quality care for conditions related headings for “adenomatous polyposis coli” (4203 results) to the colon, rectum, and anus, in addition to the devel- and “intestinal polyposis” (445 results) were included, us- opment of Clinical Practice Guidelines based on the best ing focused search. The results were combined (4629 re- available evidence. These guidelines are inclusive and not sults) and limited to English language (3981 results), then prescriptive.
    [Show full text]
  • Germline Fumarate Hydratase Mutations in Patients with Ovarian Mucinous Cystadenoma
    European Journal of Human Genetics (2006) 14, 880–883 & 2006 Nature Publishing Group All rights reserved 1018-4813/06 $30.00 www.nature.com/ejhg SHORT REPORT Germline fumarate hydratase mutations in patients with ovarian mucinous cystadenoma Sanna K Ylisaukko-oja1, Cezary Cybulski2, Rainer Lehtonen1, Maija Kiuru1, Joanna Matyjasik2, Anna Szyman˜ska2, Jolanta Szyman˜ska-Pasternak2, Lars Dyrskjot3, Ralf Butzow4, Torben F Orntoft3, Virpi Launonen1, Jan Lubin˜ski2 and Lauri A Aaltonen*,1 1Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; 2International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland; 3Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Denmark; 4Pathology and Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland Germline mutations in the fumarate hydratase (FH) gene were recently shown to predispose to the dominantly inherited syndrome, hereditary leiomyomatosis and renal cell cancer (HLRCC). HLRCC is characterized by benign leiomyomas of the skin and the uterus, renal cell carcinoma, and uterine leiomyosarcoma. The aim of this study was to identify new families with FH mutations, and to further examine the tumor spectrum associated with FH mutations. FH germline mutations were screened from 89 patients with RCC, skin leiomyomas or ovarian tumors. Subsequently, 13 ovarian and 48 bladder carcinomas were analyzed for somatic FH mutations. Two patients diagnosed with ovarian mucinous cystadenoma (two out of 33, 6%) were found to be FH germline mutation carriers. One of the changes was a novel mutation (Ala231Thr) and the other one (435insAAA) was previously described in FH deficiency families. These results suggest that benign ovarian tumors may be associated with HLRCC.
    [Show full text]
  • HPV-Negative Penile Squamous Cell Carcinoma
    Modern Pathology (2017) 30, 1013–1020 © 2017 USCAP, Inc All rights reserved 0893-3952/17 $32.00 1013 HPV-negative penile squamous cell carcinoma: disruptive mutations in the TP53 gene are common Karl Kashofer, Elke Winter, Iris Halbwedl, Andrea Thueringer, Marisa Kreiner, Stefan Sauer and Sigrid Regauer Institute of Pathology, Medical University of Graz, Graz, Austria The majority of penile squamous cell carcinomas is caused by transforming human papilloma virus (HPV) infection. The etiology of HPV-negative cancers is unclear, but TP53 mutations have been implicated. Archival tissues of 108 invasive squamous cell carcinoma from a single pathology institution in a low-incidence area were analyzed for HPV-DNA and p16ink4a overexpression and for TP53 mutations by ion torrent next-generation sequencing. Library preparation failed in 32/108 squamous cell carcinomas. Institutional review board approval was obtained. Thirty of 76 squamous cell carcinomas (43%; average 63 years) were HPV-negative with 8/33 squamous cell carcinomas being TP53 wild-type (24%; average 63 years). Twenty-five of 33 squamous cell carcinomas (76%; average 65 years) showed 32 different somatic TP53 mutations (23 missense mutations in exons 5–8, 6 nonsense, 1 frameshift and 2 splice-site mutations). Several hotspot mutations were detected multiple times (R175H, R248, R282, and R273). Eighteen of 19 squamous cell carcinomas with TP53 expression in immunohistochemistry had TP53 mutations. Fifty percent of TP53-negative squamous cell carcinomas showed mostly truncating loss-of-function TP53 mutations. Patients without mutations had longer survival (5 years: 86% vs 61%; 10 years: 60% vs 22%), but valid clinically relevant conclusions cannot be drawn due to different tumor stages and heterogeneous treatment of the cases presented in this study.
    [Show full text]
  • Lung Equivalent Terms, Definitions, Charts, Tables and Illustrations C340-C349 (Excludes Lymphoma and Leukemia M9590-9989 and Kaposi Sarcoma M9140)
    Lung Equivalent Terms, Definitions, Charts, Tables and Illustrations C340-C349 (Excludes lymphoma and leukemia M9590-9989 and Kaposi sarcoma M9140) Introduction Use these rules only for cases with primary lung cancer. Lung carcinomas may be broadly grouped into two categories, small cell and non-small cell carcinoma. Frequently a patient may have two or more tumors in one lung and may have one or more tumors in the contralateral lung. The physician may biopsy only one of the tumors. Code the case as a single primary (See Rule M1, Note 2) unless one of the tumors is proven to be a different histology. It is irrelevant whether the other tumors are identified as cancer, primary tumors, or metastases. Equivalent or Equal Terms • Low grade neuroendocrine carcinoma, carcinoid • Tumor, mass, lesion, neoplasm (for multiple primary and histology coding rules only) • Type, subtype, predominantly, with features of, major, or with ___differentiation Obsolete Terms for Small Cell Carcinoma (Terms that are no longer recognized) • Intermediate cell carcinoma (8044) • Mixed small cell/large cell carcinoma (8045) (Code is still used; however current accepted terminology is combined small cell carcinoma) • Oat cell carcinoma (8042) • Small cell anaplastic carcinoma (No ICD-O-3 code) • Undifferentiated small cell carcinoma (No ICD-O-3 code) Definitions Adenocarcinoma with mixed subtypes (8255): A mixture of two or more of the subtypes of adenocarcinoma such as acinar, papillary, bronchoalveolar, or solid with mucin formation. Adenosquamous carcinoma (8560): A single histology in a single tumor composed of both squamous cell carcinoma and adenocarcinoma. Bilateral lung cancer: This phrase simply means that there is at least one malignancy in the right lung and at least one malignancy in the left lung.
    [Show full text]
  • What Are Basal and Squamous Cell Skin Cancers?
    cancer.org | 1.800.227.2345 About Basal and Squamous Cell Skin Cancer Overview If you have been diagnosed with basal or squamous cell skin cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to start. ● What Are Basal and Squamous Cell Skin Cancers? Research and Statistics See the latest estimates for new cases of basal and squamous cell skin cancer and deaths in the US and what research is currently being done. ● Key Statistics for Basal and Squamous Cell Skin Cancers ● What’s New in Basal and Squamous Cell Skin Cancer Research? What Are Basal and Squamous Cell Skin Cancers? Basal and squamous cell skin cancers are the most common types of skin cancer. They start in the top layer of skin (the epidermis), and are often related to sun exposure. 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer cells. To learn more about cancer and how it starts and spreads, see What Is Cancer?1 Where do skin cancers start? Most skin cancers start in the top layer of skin, called the epidermis. There are 3 main types of cells in this layer: ● Squamous cells: These are flat cells in the upper (outer) part of the epidermis, which are constantly shed as new ones form. When these cells grow out of control, they can develop into squamous cell skin cancer (also called squamous cell carcinoma).
    [Show full text]
  • Immunohistochemical Differential Diagnosis Between Thymic Carcinoma and Type B3 Thymoma: Diagnostic Utility of Hypoxic Marker, GLUT-1, in Thymic Epithelial Neoplasms
    Modern Pathology (2009) 22, 1341–1350 & 2009 USCAP, Inc. All rights reserved 0893-3952/09 $32.00 1341 Immunohistochemical differential diagnosis between thymic carcinoma and type B3 thymoma: diagnostic utility of hypoxic marker, GLUT-1, in thymic epithelial neoplasms Masakazu Kojika1,2, Genichiro Ishii1, Junji Yoshida2, Mituyo Nishimura2, Tomoyuki Hishida2, Shu-ji Ota1, Yukinori Murata1, Kanji Nagai2 and Atsushi Ochiai1 1Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan and 2Thoracic Surgery Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan There are only a few immunohistochemical markers that are useful for differentiating thymic carcinomas from type B3 thymomas. The purpose of this study is to examine the additional markers that would be useful for differentiating between thymic carcinoma and thymoma type B3. We performed a tissue microarray analysis of surgically resected thymic tumor specimens from12 cases of thymic carcinoma, 7 cases of type B3 thymoma, and 68 cases of other types of thymoma. Immunostaining using 49 antibodies was scored based on staining intensity and the percentage of cells that stained positive. Seven proteins that were selected by the staining scores, namely, GLUT-1 (167 vs 4), CA-IX (110 vs 15), c-kit (162 vs 44), CD5 (33 vs 0), MUC-1 (54 vs 0), CEA (42 vs 0), and CK18 (110 vs 42), were significantly higher in the thymic carcinomas than in the type B3 thymomas. The staining sensitivity and specificity of the antibodies for thymic carcinoma were GLUT-1, sensitivity 72% and specificity 100%; CA-IX, 58 and 71%; c-kit, 72 and 85%; CD5, 33 and 100%; CK18, 58 and 71%; MUC-1, 25 and 100%; and CEA, 33 and 100%.
    [Show full text]
  • Pathology and Classification of SCLC
    cancers Review Pathology and Classification of SCLC Maria Gabriela Raso * , Neus Bota-Rabassedas and Ignacio I. Wistuba * Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; [email protected] * Correspondence: [email protected] (M.G.R.); [email protected] (I.I.W.); Tel.: +1-713-834-6026 (M.G.R.); +1-713-563-9184 (I.I.W.) Simple Summary: Small cell lung carcinoma (SCLC), is a high-grade neuroendocrine carcinoma defined by its aggressiveness, poor differentiation, and somber prognosis. This review highlights cur- rent pathological concepts including classification, immunohistochemistry features, and differential diagnosis. Additionally, we summarize the current knowledge of the immune tumor microenvi- ronment, tumor heterogeneity, and genetic variations of SCLC. Recent comprehensive genomic research has improved our understanding of the diverse biological processes that occur in this tumor type, suggesting that a new era of molecular-driven treatment decisions is finally foreseeable for SCLC patients. Abstract: Lung cancer is consistently the leading cause of cancer-related death worldwide, and it ranks as the second most frequent type of new cancer cases diagnosed in the United States, both in males and females. One subtype of lung cancer, small cell lung carcinoma (SCLC), is an aggressive, poorly differentiated, and high-grade neuroendocrine carcinoma that accounts for 13% of all lung carcinomas. SCLC is the most frequent neuroendocrine lung tumor, and it is commonly presented as an advanced stage disease in heavy smokers. Due to its clinical presentation, it is typically diagnosed in small biopsies or cytology specimens, with routine immunostaining only. However, Citation: Raso, M.G.; immunohistochemistry markers are extremely valuable in demonstrating neuroendocrine features of Bota-Rabassedas, N.; Wistuba, I.I.
    [Show full text]
  • (NCCN Guidelines®) Thymomas and Thymic Carcinomas
    NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Thymomas and Thymic Carcinomas Version 2.2019 — March 11, 2019 NCCN.org Continue Version 2.2019, 03/11/19 © 2019 National Comprehensive Cancer Network® (NCCN®), All rights reserved. NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN. NCCN Guidelines Index NCCN Guidelines Version 2.2019 Table of Contents Thymomas and Thymic Carcinomas Discussion *David S. Ettinger, MD/Chair † Ramaswamy Govindan, MD † Sandip P. Patel, MD ‡ † Þ The Sidney Kimmel Comprehensive Siteman Cancer Center at Barnes- UC San Diego Moores Cancer Center Cancer Center at Johns Hopkins Jewish Hospital and Washingtn University School of Medicine Karen Reckamp, MD, MS † ‡ *Douglas E. Wood, MD/Vice Chair ¶ City of Hope National Medical Center Fred Hutchinson Cancer Research Matthew A. Gubens, MD, MS † Center/Seattle Cancer Care Alliance UCSF Helen Diller Family Gregory J. Riely, MD, PhD † Þ Comprehensive Cancer Center Memorial Sloan Kettering Cancer Center Dara L. Aisner, MD, PhD ≠ University of Colorado Cancer Center Mark Hennon, MD ¶ Steven E. Schild, MD § Roswell Park Cancer Institute Mayo Clinic Cancer Center Wallace Akerley, MD † Huntsman Cancer Institute Leora Horn, MD, MSc † Theresa A. Shapiro, MD, PhD Þ at the University of Utah Vanderbilt-Ingram Cancer Center The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Jessica Bauman, MD ‡ † Rudy P. Lackner, MD ¶ Fox Chase Cancer Center Fred & Pamela Buffett Cancer Center James Stevenson, MD † Case Comprehensive Cancer Center/ Ankit Bharat, MD ¶ Michael Lanuti, MD ¶ University Hospitals Seidman Cancer Center Robert H. Lurie Comprehensive Cancer Massachusetts General Hospital Cancer Center and Cleveland Clinic Taussig Cancer Institute Center of Northwestern University Ticiana A.
    [Show full text]
  • Kidney Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis
    cancer.org | 1.800.227.2345 Kidney Cancer Early Detection, Diagnosis, and Staging Detection and Diagnosis Catching cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. ● Can Kidney Cancer Be Found Early? ● Kidney Cancer Signs and Symptoms ● Tests for Kidney Cancer Stages and Outlook (Prognosis) After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. ● Kidney Cancer Stages ● Survival Rates for Kidney Cancer Questions to Ask About Kidney Cancer Here are some questions you can ask your cancer care team to help you better understand your cancer diagnosis and treatment options. ● Questions to Ask About Kidney Cancer 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Can Kidney Cancer Be Found Early? Many kidney cancers are found fairly early, while they are still limited to the kidney, but others are found at a more advanced stage. There are a few reasons for this: ● These cancers can sometimes grow quite large without causing any pain or other problems. ● Because the kidneys are deep inside the body, small kidney tumors cannot be seen or felt during a physical exam. ● There are no recommended screening tests for kidney cancer in people who are not at increased risk. This is because no test has been shown to lower the overall risk of dying from kidney cancer. For people at average risk of kidney cancer Some tests can find some kidney cancers early, but none of these is recommended to screen for kidney cancer in people at average risk.
    [Show full text]
  • Update on Small Cell Carcinoma and Its Differentiation from Squamous Cell Carcinoma and Other Non-Small Cell Carcinomas
    Modern Pathology (2012) 25, S18–S30 S18 & 2012 USCAP, Inc. All rights reserved 0893-3952/12 $32.00 Update on small cell carcinoma and its differentiation from squamous cell carcinoma and other non-small cell carcinomas William D Travis Department of Pathology, Attending Thoracic Pathologist, Memorial Sloan Kettering Cancer Center, New York, NY, USA Small cell lung cancer (SCLC) comprises 14% of all lung cancers, and 430 000 new cases are diagnosed per year in the United States. SCLC is one of the most distinctive malignancies in the entire field of oncology with characteristic clinical properties, responsiveness to specific chemotherapy, genetic features and a highly reliable pathological diagnosis. SCLC is defined by light microscopy, and the most important stain is a good- quality hematoxylin and eosin (H&E)-stained section. The vast majority of cases can be diagnosed on H&E alone; however, in problem cases, immunohistochemistry can be very helpful in making the distinction from other tumors. Cytology is also a powerful tool, often being more definitive than small biopsies with scant tumor cells, crush artifact and/or necrosis. As virtually all SCLCs present in advanced stages, most patients are diagnosed based on small biopsy and cytology specimens. Historically, there has been significant evolution in the histological subclassification of SCLC dating from 1962 when Kreyberg proposed the oat cell and polygonal cell types. The current subclassification recognizes only two subtypes: pure SCLC and combined SCLC. Pathologists need to do their best to make a diagnosis of SCLC or other histological types of lung cancer and this can be achieved in most cases.
    [Show full text]
  • Neuroendocrine Neoplasms of the Pancreas: the Pathological Viewpoint
    JOP. J Pancreas (Online) 2018 Dec 31; S(3):328-334. REVIEW ARTICLE PANCREATIC NEUROENDOCRINE TUMORS Neuroendocrine Neoplasms of the Pancreas: The Pathological Viewpoint Noriyoshi Fukushima Department of Diagnostic Pathology, Jichi Medical University Hospital, Tochigi, Japan ABSTRACT Neuroendocrine neoplasms of the pancreas are relatively rare, accounting for approximately 1–2% of all pancreatic neoplasms, and are composed of epithelial neoplastic cells with neuroendocrine differentiation. Neuroendocrine neoplasms are potentially malignant neoplasms including well-differentiated types (neuroendocrine tumors, neuroendocrine tumors) and poorly differentiated types neoplasms of the digestive system. “Endocrine neoplasm” was changed to “neuroendocrine neoplasm”. Neuroendocrine neoplasms are (neuroendocrine carcinomas). The WHO classification released in 2010 led to a significant change in the grading system of neuroendocrine graded according to the number of mitoses and/or Ki-67 index. These changes simplified the classification scheme. However, there are a number of remaining issues. Neuroendocrine tumors meeting the WHO criteria for neuroendocrine carcinoma (>20 mitoses/10 high (gradepower fields3) neuroendocrine and/or Ki67 neoplasms,index > 20%) they with are a divided well-differentiated into pancreatic morphology, neuroendocrine known tumors, as an “organoid grade 3 (PanNET pattern” G3) have and been neuroendocrine identified. In carcinomas,the revised version grade 3of (PanNEC the “WHO G3) Classification depending ofon Tumours their histo-morphologic of Endocrine Organs” characteristics. published inThe 2017, neuroendocrine to solve the problems tumor G3 of categoryhigh-grade is using a combination of tumor morphology and cell proliferation is important. Better strategies to treat and improve the outcomes of patientsassociated with with pancreatic a better prognosis neuroendocrine and does neoplasms not significantly are required.
    [Show full text]